The Role Of Combined Detection Of INOS MRNA-iNOS And NO In The Treatment And The Prognosis Decision Of AR

[Objective]To detect the level of NO、iNOS and EOS of AR patients’peripheral blood before and after the local use of corticoid, and then combine the clinical symptoms and signs scoring. Access the efficacy according to the two above indicators and find out convinent laboratory parameters for the clinical treatment and evaluation of AR.[Material and Methods]1. Experimental patients and groups:We set up an experiment group consist of59AR patients from outpatients who meet the diagnostic criteria and the skin pink test result were all positive. The control group consisted of50cases who are all health-examined individuals.2. The time of follow-up is24weeks. The next visit time is every four weeks’local use corticosteroids by doctor’s advice. Observe and record the symptoms and signs of the patients who come for a follow-up visit.3. Methods:to collect the peripheral blood of patients and healthy individous and detet the peripheral blood leukocyte iNOS-mRNA levels of each test subject by real time PCR and determine the serum iNOS levels by ELISA. NO in plasm was measured by nitrate reductase. The peripheral blood EOS count adopted conventional method.[Results]1. The change of clinical sypotoms and physical signs of AR patients after local use corticosteroids by doctor’s advice:From start to the6th month,8cases of59AR patients were removed from the experiment early. At the second visit, the clinical sympotoms and physical signs are all effectively improved.34had mark effect,16had effect,1no dffect and the total effective rate is98%.The treatment of the ineffective patient is the combination of drugs corticosteroids and antihistamine in the next four weeks. At the third visit, the above ineffective patient’sympotoms and signs were improved effectively.5cases of50effecive patients relapse and others are in a stable condition. The recurrence patients also receive the combination of drugs corticosteroids and antihistamine in the next four weeks. At the fourth visit,4patients who had good treatment effect in the past month appeared severious clinical sympotoms again after the second months’treatment. The others are satisfied with the result. In the next weeks, they were given the half dose of corticosteroids. The new relapse patients use the same treatment as other recurrence cases in the next four weeks. At the fifth visit, no recurrences occurred and among the10patients who use corticosteroids and antihistamine.4cases were satisfied with the result.6cases whose symptoms and signs were not improved give up the current treatment. No new recurrence appeared until the end of the follw-up.2. To measure the NO levels in plasm by nitrate reductase.The level of plasm NO in the patients with allergic rhinitis were significantly higher than the healthy group (p<0.01).There was significant reduction of NO in the patients after therapy (p<0.01).3. To determine the serum iNOS levels by ELISA. The peripheral blood EOS count adopted conventional method.a) The peripheral blood EOS levels of experimental subjects:The number of peripheral blood EOS in the patients with allergic rhinitis befor and after treatment were significantly higher than the healthy group (p<0.05). After treatment, the peripheral blood EOS count decreased markedly (p>0.05). b) The peripheral blood iNOS level of experimental subjects:The level of plasm iNOS in the patients with allergic rhinitis were significantly higher than the healthy group (p<0.05).There was significant reduction of iNOS in the patients after therapy (p<0.01).4. To determine the peripheral blood leukocyte iNOS mRNA levels by real time PCR.The peripheral blood leukocyte iNOS mRNA level of the patients with allergic rhinitis were significantly higher than the healthy group (p<0.05).There was significant reduction of iNOS mRNA of the patients after therapy (p<0.01).[Conclusions]1. Corticosteroids can improve the symptoms and signs of AR patients by decreasing the peripheral blood iNOS, NO and EOS levels. And the level of NO in plasm was related with the high rate of the expression of iNOS in the plasm and iNOS-mRNA in the peripheral blood leukocyte.2. The recurrence rate of remarkable effect AR patients after local use corticosteroids is far lower than the effect cases. Long-term use of corticosteroids can effectively control the symptoms.3. Determination of the NO, iNOS. iNOS mRNA and EOS can be of use in accessing therapeutic efficacy and help further treatment.We find out convinent laboratory parameters for the clinical treatment and evaluation of AR.